Histrionic Personality Disorder

Histrionic personality disorder!

A pervasive pattern of excessive emotionality and attention-seeking, beginning in early adulthood, including inappropriately seductive behaviour and an excessive need for approval which is present in a variety of contexts, as indicated by five (or more) of the following:

  • Is uncomfortable in situations in which he or she is not the centre of attention
  • Interaction with others is often characterized by inappropriate sexually seductive or provocative behaviour
  • Displays rapidly shifting and shallow expression of emotions
  • Consistently uses physical appearance to draw attention to self
  • Has a style of speech that is excessively impressionistic and lacking in detail?
  • Shows self-dramatization, theatricality, and exaggerated expression of emotion
  • Is suggestible, i.e., easily influenced by others or circumstances
  • Considers relationships to be more intimate than they actually are.

The DSM-IV requires that a diagnosis for any specific personality disorder also satisfies a set of general personality disorder criteria. The World Health Organization’s ICD-10 lists histrionic personality disorder as:

  • shallow and labile affectivity,
  • self-dramatization,
  • theatricality,
  • exaggerated expression of emotions,
  • suggestibility,
  • egocentricity,
  • self-indulgence,
  • lack of consideration for others,
  • easily hurt feelings, and
  • Continuous seeking for appreciation, excitement and attention.

 

Histrionic people are lively, dramatic, vivacious, enthusiastic, and flirtatious. People with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to manipulate others into making them the centre of attention. HPD may also affect a person’s social and/or romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.

Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.

A mnemonic that can be used to remember the characteristics HPD is shortened as PRAISE ME!

  • Provocative (or seductive) behaviour
  • Relationships are considered more intimate than they actually are
  • Attention-seeking
  • Influenced easily by others or circumstances
  • Speech (style) wants to impress; lacks detail
  • Emotional lability; shallowness
  • Make-up; physical appearance is used to draw attention to self
  • Exaggerated emotions; theatrical

Lustfulness is a projection of the patient’s lack of ability to love unconditionally and develop cognitively to maturity, and such patients were overall – emotionally shallow.

The common perception is that the reason of not being able to love could have been from a traumatic death experience from a close relative during childhood or divorce between parents, which gave the wrong impression of committed relationships.

Women are hypersexualized in the media consistently, ingraining thoughts that the only way women are to get attention is by exploiting themselves, and when seductiveness isn’t enough, theatricals are the next step in achieving attention.

Men can just as well be flirtatious towards multiple women yet feel no empathy or sense of compassion towards them. They may also be the centre of attention by exhibiting the “Don Juan” macho figure as a role-play.